Moins connu car moins massif et moins étudié, le mycobiote intestinal remplit également des rôles et des fonctions physiologiques indispensables, nécessaires au bon fonctionnement de notre organisme. À l’instar du microbiote intestinal, des perspectives existent quant aux intérêts thérapeutiques futurs de sa modulation par des interventions cliniques. 

Notre organisme n’abrite pas que des bactéries. Il est le siège d’une multitude de micro-organismes. Parmi eux, les champignons. Des champignons parfois oubliés par la recherche scientifique parce qu’ils ne représentent que 0,01 à 0,1 % de l’ensemble des micro-organismes qui vivent en symbiose avec nous. Entre 2008 et 2018, il y a eu 100 fois plus de publications scientifiques relues par les pairs sur le microbiote (qui concerne essentiellement les bactéries) que sur le mycobiote (qui concerne essentiellement les champignons). Pour relancer un peu l’intérêt sur le mycobiote, des chercheurs américains et chinois parlent en détail de ce que nous connaissons de ce mycobiote dans une revue de la littérature publiée dans le journal Microbiome.

La colonisation de notre mycobiote commencerait très tôt. Plusieurs hypothèses s’affrontent encore, mais selon certaines d’entre elles, cela pourrait être même avant notre naissance. Ensuite, ce dernier accroît sa diversité alpha (la diversité et le nombre de micro-organismes dans un échantillon donné) jusqu’à ce que l’hôte atteigne l’âge de deux ans tandis que la diversité bêta (la diversité et le nombre de micro-organismes entre plusieurs échantillons) atteint son pic 10 jours après la naissance. À l’instar du microbiote, sa composition varie dans le temps et certaines espèces dominent selon les différents stades du développement de l’hôte. En conservant cette analogie, les facteurs qui influencent sa composition sont sensiblement similaires à ceux du microbiote : le mode de naissance, l’alimentation, l’hygiène excessive, les saisons, la génétique, les maladies, etc. 

De même que nos bactéries, nos champignons nous sont utiles. L’équilibre du mycobiote est nécessaire au bon fonctionnement de certaines voies métaboliques. Par exemple, une étude publiée en 2017 a démontré chez la souris que la présence importante d’une levureSaccharomyces cerevisiae, pouvait exacerber la production d’acide urique et ainsi provoquer une aggravation de pathologies comme la colite. Mené à mal (respectivement, à bien), cet équilibre pourrait aussi accélérer (respectivement ralentir) le vieillissement cellulaire et l’évolution de certaines maladies intestinales, mais la recherche sur le sujet n’en est pour l’instant qu’à ses prémices. 

Bien évidemment, cet équilibre joue aussi un précieux rôle dans l’homéostasie immunitaire. Certaines levures comme Saccharomyces cerevisiae pourraient participer au bon développement de certaines cellules immunitaires grâce à la présence, sur leur paroi cellulaire, de nombreux ligands associés à certains récepteurs des cellules de l’immunité innée. De même, ils peuvent parfois activer des cascades de réactions inflammatoires. Par exemple, ce serait Candida Albicans qui permettrait aux neutrophiles de libérer de l’ADN nucléaire pour former un réseau dans le but de piéger et tuer des micro-organismes pathogènes extracellulaires. Enfin, nos champignons joueraient aussi un rôle dans la différenciation de certaines cellules immunitaires et dans la production de certains métabolites

Comme nous le disions précédemment, l’équilibre du mycobiote est aussi associé à des états sains ou pathologiques. Comme son acolyte, le microbiote, la recherche clinique cherche à mieux comprendre ce qui relie une composition donnée chez un hôte et un état clinique. L’objectif, moduler le mycobiote pour guérir ou améliorer la qualité de vie des malades. La recherche fondamentale ouvre beaucoup de pistes étant donné qu’il existerait des connexions entre notre mycobiote et la plupart de nos organes : l’intestin, le cerveau, les poumons, le foie, les reins et le pancréas. Pour autant, il faut rester très prudent. L’étude acharnée du microbiote ne nous permet pour l’instant d’agir que dans une seule indication thérapeutique : l’infection à Clostridium difficile, via la transplantation fécale. Il faudra encore du temps à la recherche fondamentale, pré-clinique et clinique avant de pouvoir voir émerger un quelconque traitement. 

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